Impact of Team Training                          and Certification of Staff on Patient Outcomes, Staff Performance and Staff Perception of Arrests

Overcoming the Influence of Hierarchy on Team behavior via Multidisciplinary Team Based Training

Robust medical simulation has become increasingly important for education in arrest management. It permits not only teaching of protocols and

empirical algorithms, but can improve the hands-on skills of rescuers without harming patients or traumatizing inexperienced rescuers. Further,

it allows practice of situations that occur infrequently, but where rapid application of necessary skills and knowledge is crucial, such as in post

cardiac surgery cardiac arrest.

Successful arrest management relies on the immediate and skilled action of first responders. Once the resuscitation team arrives, a seamless

have demonstrated that nurses may be hesitant to initiate resuscitation protocols, such as use a defibrillator in the absence of a physician, despite

adequate technical training on its use and indications, due to the influence of hierarchy on team behavior. 

The CSU-ALS courses emphasize team based training that deconstructs the hierarchal approach to arrest, invites all members of the team to take

initiative at the beginning of the arrest to initiate the protocol and to take on leadership roles.  Training as a multidisciplinary team reinforces these

principals and results in more efficient assumption of roles and carrying out of the arrest protocol.  This efficiency translates into improved outcomes,

as demonstrated in simulation, anecdotally shared by teams in post arrest debriefing, as well as recent single center and a single multicenter

study that have demonstrated improvement in Failure to Rescue and reduced arrest rates versus non CSU-ALS training centers.  

commitment, in turn, translates to a higher level of competence and expertise, leading to better patient outcomes.  

Certified teams consistently report increased confidence and comfort with arrest management during post arrest debriefs, regardless

of the outcome for the patient, as they feel at least they have been trained and prepared for the arrest.